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Effectiveness of a home-based, post-discharge early intervention program for very preterm infants in reducing
Juan Fan1, Ruiyun He1, Shasha He1
1Department of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, No 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014, China.
Insights
A home-based early intervention (EI) program significantly reduced parental stress in families with very preterm infants. This intervention improved parental well-being and child-rearing confidence post-discharge.
Area of Science:
- Neonatal Care
- Parental Health
- Psychological Interventions
Background:
- Preterm infants (28+\u20090–31+\u20096 weeks gestational age) face significant health challenges.
- Parental stress is a common issue in families with very preterm infants.
- Early intervention programs can support families during the critical post-discharge period.
Purpose of the Study:
- To evaluate the effectiveness of a home-based early intervention (EI) program.
- To assess the impact of EI on parental stress levels in families with very preterm infants.
- To compare EI with standard care (SC) and a term infant reference group.
Main Methods:
- Randomized controlled trial comparing EI and SC groups.
- Parental stress assessed using the Parental Stress Index-Short Form at baseline, 60 days, and 6 months corrected age.
- EI program included intellectual, physical, and social training for infants and parents.
Main Results:
- Parents in the EI group reported significantly lower total stress scores at 60 days compared to the SC group (p < 0.001).
- Reductions in parental distress and parental-child interaction dysfunction subdomains were observed in the EI group.
- Mothers showed a more pronounced stress reduction than fathers in the EI group (p < 0.001).
Conclusions:
- The home-based EI program is effective in reducing parental stress for families with very preterm infants.
- Early intervention positively impacts parental well-being during the critical post-discharge phase.
- EI demonstrates a significant benefit over standard care in managing parental stress.
Background:
This study aims to evaluate the impact of a home-based, post-discharge early intervention (EI) program on reducing parental stress levels in families with preterm infants born between 28+ 0 and 31+ 6 weeks gestational age.
Methods:
A randomized controlled trial was conducted, with families randomly allocated to either the EI or standard care (SC) group. A term reference group was also recruited for comparison. The Parental Stress Index-Short Form was used to assess parental stress levels, yielding a total stress score and three subdomain scores. Assessment was performed at baseline, at the 60-day mark of the study, and when the infants reached six corrected months of age. Parents in the reference group were assessed only at six months of corrected age for infants. The intervention comprised three sections: intellectual, physical, and social training, which was administered to the infants in the EI group immediately after discharge and to those in the SC group after 60 days of enrollment.
Results:
Seventy-three families were enrolled in this study, with 37 allocated to the EI group, and 36 to the SC group. Prior to intervention, higher stress levels were reported by mothers in both groups than fathers, with no difference observed between the EI and SC groups. Re-assessment performed at 60 days of the study showed that mothers and fathers in the EI group had significantly lower total stress score than those in the SC group (82.00 ± 5.64 vs. 94.26 ± 7.99, p < 0.001; 80.74 ± 7.14 vs. 89.94 ± 9.17, p < 0.001, respectively), which was predominantly due to the lower scores in parental distress and parental-child dysfunction interaction subdomains in the EI group (both had p < 0.001). Mothers in the EI group exhibited a more pronounced reduction in total stress score after intervention when compared to fathers (13.15 ± 4.68 vs. 8.26 ± 4.03, p < 0.001). At six months of infant age, the total stress score and subdomain scores of parents in the EI and SC groups were similar, but significantly higher than those of the reference group.
Conclusion:
The home-based, post-discharge EI program demonstrated significant effectiveness in reducing parental stress levels among the parents of very preterm infants.
Trial Registration:
This study was registered in the Chinese Clinical Trial Registry (registration number: CTR1900028330). Registration date: December 19, 2019.
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